Patient Guide Epworth Richmond. Swipe for more information

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1 1 Patient Guide Epworth Richmond

2 Welcome to Epworth Richmond 2 The one goal that drives everything we do is to improve patients lives. We are committed to your care, which in addition to your clinical care includes your physical comfort, communication and wellbeing needs. Your satisfaction in these areas contributes to our delivery of excellence in patient care and clinical services. This Point of Care patient guide has been developed to help you, your family and friends find general information that will assist during your stay. We aim for your stay to be as comfortable as possible; please let us know if we can be of any assistance. We also value your feedback which helps us identify where we are doing well and where we can make improvements. Please feel confident to speak with your nurse or unit manager or, if you prefer, you may provide feedback online at All feedback is treated confidentially. Thank you for entrusting us with your care. For information pertaining to your individual care, we encourage you to ask questions of your team and seek clarification if you are unsure of anything during your stay. Nicole Waldron Executive Director Epworth Richmond Alan R Kinkade Group Chief Executive

3 Patient guide quick reference 3 About Epworth HealthCare 4 About Epworth Richmond 5 Your rights and responsibilities 7 Patient privacy 8 Facilities and amenities 9 Retail options 10 Useful contacts 11 During your stay 12 Your care team 16 Your safety in hospital 18 Planning for discharge 22 Accounts and out-of-pocket costs 25 Epworth Medical Foundation 27 Compliments and complaints 28 Private Patient s Hospital Charter 29 Scroll Swipe down for more information

4 About Epworth HealthCare 4 Excellence Epworth HealthCare is Victoria s largest not for profit private health care group, renowned for excellence in diagnosis, treatment, care and rehabilitation. Epworth is an innovator in Australia s health system, embracing the latest in evidence-based medicine to pioneer treatments and services for our patients. Everywhere We have a number of locations across the Melbourne metropolitan area, including Epworth Brighton, Epworth Camberwell, Epworth Cliveden (East Melbourne), Epworth Eastern (Box Hill), Epworth Freemasons (East Melbourne), Epworth Hawthorn and Epworth Richmond, as well as specialist centres in Berwick and Lilydale. In 2016 we opened our new teaching hospital, Epworth Geelong, in partnership with Deakin University, to provide healthcare to Victoria s growing western corridor. Everyday From the birth of your child, to cardiac care, rehabilitation, a hip replacement, robotic surgery, comprehensive cancer treatment or any of our 40 specialties, we have the specialists, facilities, staff and support to care for you 24 hours a day, seven days a week.

5 About Epworth Richmond 5 Specialising in cardiovascular, orthopaedics, neurosciences, emergency medicine and oncology medicine, Epworth Richmond is dedicated to meeting the healthcare needs of Victorians. We are Victoria s largest private not-for-profit hospital, with close to 47,000 annual admissions, more than 1800 staff members and 1200 accredited visiting specialists. Epworth Richmond is a leader in oncology medicine, providing comprehensive, integrated and holistic care to patients undergoing chemotherapy, haematology and non-malignancy treatments. Our 24-chair Day Oncology Unit (located within the Day Medical Unit) is supported by a 50 bed inpatient unit. Epworth Radiation Oncology is equipped with the latest technology to provide best practice care for all patients. Radiation therapy services sit alongside Epworth Richmond medical and surgical facilities enabling the coordination of all treatment needs within one service. Located in the new Lee Wing and accessed from Erin Street, Epworth Richmond s Emergency Department treats more emergency cases than any other private hospital emergency department in Victoria. Clinical care is provided 24/7 by experienced emergency physicians, nursing and medical staff, complemented by excellent diagnostic services including radiology and pathology. Epworth Richmond is also home to the largest private Intensive Care Unit in Victoria and four catheter laboratories provide cardiac and vascular interventions, 24 hours a day. Epworth Richmond Clinical Specialties include: Breast surgery Cancer services Cardiac services Colorectal surgery Critical care Ear, nose and throat Emergency medicine Head and neck General surgery Gastroenterology Gynaecology General Medicine Neurology Neurosurgery Orthopaedics Oral and maxillofacial surgery Plastics Renal Medicine/ Nephrology Respiratory Robotic surgery Urology Vascular Services include: Epworth Dermatology Epworth Allergy Specialists Epworth consulting suites Renal Dialysis Unit

6 About Epworth Richmond 6 Specialist nursing services include: Acute pain nurse Breast care nurse Care coordinators Complex discharge liaison Diabetes educator Palliative care consultant Stomal therapist Thoracic liaison nurse consultant

7 Your rights and responsibilities 7 Epworth endorses the Australian Government s Private Patient s Hospital Charter which describes the rights of privately insured patients admitted to a public or private hospital. The charter outlines what it means if you are seeking or receiving care from a public or private healthcare service, including what you can expect from services and what to do if you have a question or concern. Patient responsibilities As a patient of Epworth, you have the responsibility to: provide information about your present and past illnesses, hospitalisations, medications and other matters relating to your health history ask questions if you do not understand explanations given about risks and benefits of your healthcare, directions or procedures help your doctor, nurse and healthcare support staff in their efforts to care for you by following their instructions and medical orders report safety concerns immediately to your doctor, nurse or any healthcare support staff ask questions of your treating doctor, specialist, health insurer or hospital about likely costs before you go to hospital. You must also be responsible for the payment of all services, either through your third party payers (insurance company, Transport Accident Commission etc) or by personally making payment for any service that is not covered by your insurance policy(s) including second opinions and consultations. Patient rights As a private patient you have the right to choose your own doctor, and decide whether you will go as a private patient to a public or a private hospital that your doctor attends. Even if you have private health insurance, you can choose to be treated as a public patient in a public hospital, at no charge, by a doctor appointed by the hospital. You also have the right to: information about your diagnosis, treatment, associated risks and treatment options information from your doctor or health service on the costs of your proposed treatment, including any likely out of pocket expenses seek other medical opinions about your condition information on visiting arrangements for your family and friends while you are in hospital confidentiality of, and access to, your medical records treatment with respect and dignity care and support from nurses and allied health professionals participate in decisions about your care make a comment or complaint about any aspect of your hospital treatment. The Australian Government s Private Patient s Hospital Charter is located on page 29 of this guide.

8 8 Patient privacy Epworth HealthCare is committed to protecting the privacy and confidentiality of the personal information (including health information and other sensitive information) that it collects and uses. Epworth complies with its obligations under all applicable privacy and health records laws, including the Privacy Act 1988 (Cth) (and its Australian Privacy Principles) and the Health Records Act 2001 (Vic) (and its Health Privacy Principles). Epworth recognises that the privacy principles under those laws apply to our relationship with patients, employees and service providers. Epworth requires that all health professionals and organisations doing business with us will similarly adhere to those privacy principles. This privacy policy applies to all of the hospitals and health services operated by Epworth. For further information around our privacy policy and how Epworth collects, uses and discloses and protects personal information, please visit About Us at epworth.org.au. This privacy policy explains how Epworth manages the personal information that we collect, use and disclose; it also describes how you may contact us if you have any questions or complaints about your privacy or would like to access the personal information we hold about you.

9 9 Facilities and amenities Car parking The car park is accessed via Bridge Road. A discount rate is available for long term patients and visitors using the car park over a period of seven days or more, subject to conditions. Patients and family members seeking a discount pass card should make enquiries through their unit once admitted, or via the car park office. The car park office is located on Level B, Bridge Road, ph ext Car parking rates 0-30 mins $ mins - 1 hr $ hr hrs $ hrs - 2 hrs $ hrs hrs $ hrs - 3 hrs $ hrs hrs $ hrs - 4 hrs $50.00 Main reception Dial 99 on your bedside phone to contact main reception between 6am and 10.30pm. Main reception is located on Level 2. Newspapers and magazines Newspapers and magazines can be purchased from the newspaper vendor who visits the wards each day. Patient drop-off and pick-up zones Patients may be dropped off or picked up at the Bridge Road entrance or the Erin Street entrance. Cars can wait at either of these entrances for a maximum of five minutes. When planning your discharge please speak with nursing staff about whether you will need wheelchair assistance to leave hospital. Patient library A volunteer visits each floor on a regular basis with books available for loan or you can request a visit through our volunteer coordinator ph from your bedside phone. This is a complimentary service. Public transport Epworth Richmond can be reached from the city by tram 48 towards North Balwyn from Collins Street or tram 75 towards East Burwood from Flinders Street. The closest stop for the Bridge Road entrance is tram stop number 15. By train the closest station to Epworth Richmond is West Richmond station (South Morang and Hurstbridge lines) which is a five minute walk away. Richmond station on Swan Street is a 15 minute walk away. Taxis Complimentary taxi phones are available at both the Bridge Road and Erin Street entrances. Taxis can drop off and pick up in the turning circles at either entrance. 4 hrs - 6 hrs $60.00

10 10 Retail options Florist Ngenious Floriade Florist Located at the Bridge Road entrance, is open seven days a week. The florist provides the highest quality flower arrangements with delivery to all Epworth hospitals, including free delivery to Epworth Richmond. Orders for flowers can be arranged online or by telephoning or am 8.30pm Monday to Friday, Saturday 9am 7pm, and Sunday 10am 7pm. (Please note: Lilies are known to cause allergies and related symptoms in some people. In order to protect our patients, staff and visitors from this known allergen, Epworth does not allow lilies to be brought into any of our hospitals. All other flowers are welcome.) Pharmacy Slade Pharmacy Located at the Bridge Road entrance, Slade Pharmacy stocks an extensive product range including specialised healthcare products such as compression stockings, nutritional support, continence aids, home healthcare aids, asthma and diabetes products, advanced wound care treatments as well as prestige skincare, cosmetics and fragrances. If you require any non-medication items from the pharmacy during your hospital stay, please visit the pharmacy to purchase these items. These items will not be added to your hospital medication account. For further information please contact the pharmacy team at Slade Pharmacy within opening hours. Open: 8am 10pm, 7 days a week. Ph: Where to eat - visitors EpiCentre Cafe Located on Level 2 near main reception. The cafe sells an array of hot meals, sandwiches, snacks and drinks. Open: Monday to Friday 6.45am 7pm and Saturday and Sunday 8.30am 6.30pm. A fully vended service is available 24 hours a day, seven days a week. Hudsons Coffee Located on ground floor near the Bridge Road entrance. Light refreshments are available including a selection of coffees, hot and cold snacks, cakes and sandwiches. Open: Monday to Friday 7am 8pm, Saturday and Sunday 8am 8pm. There are also many eating options available within walking distance on Bridge Road.

11 11 Useful contacts Epworth Richmond Main Reception Dial 99 (internal phone); or: Patient Accounts Slade Pharmacy Pharmacy Accounts Epworth Pathology Accounts Epworth Medical Imaging Accounts Epworth Medical Foundation Patient Services

12 12 During your stay Accommodation Epworth Richmond provides both private and shared room accommodation. Please speak with your nurse if your preference is for a private room. There may be occasions where we are unable to accommodate your requests however we will endeavor to meet your needs as quickly as possible. All patient rooms have a nurse call button located on a hand set at the bedside, television, radio and a telephone. In-house movies are played on channel 8, 11 and 12. A different movie is played on each channel daily, beginning every three hours from midnight. The movie program is available on channel 1. The Point of Care system you are using to read this information is scheduled to be installed across all patient beds across Epworth HealthCare locations during 2016 and Flowers Lilies are known to cause allergies and related symptoms in some people. In order to protect our patients, staff and visitors from this known allergen, Epworth does not allow lilies to be brought into any of our hospitals. All other flowers are welcome. Meals and food services Each day you will be visited by one of our menu monitors who will record your meal choices via an electronic ordering system from a menu prepared by our team of chefs. All menus are prepared in accordance with Australian dietary guidelines. You can expect a high standard of meals and food preparation because: we have onsite kitchens producing fresh meals we use seasonal produce we have regular internal and external audits to check cleanliness, the safety and quality of our food, food preparation and kitchens. We understand that excellent nutrition is vital to recovery from illness or surgery. The best way for us to support your nutrition is to ensure we provide appetising, healthy meals made from quality fresh produce. We endeavour to meet your dietary needs while you are with us. Due to our diverse patient population we are aware of and pleased to accommodate your specific needs, whether they are based on cultural, religious, personal preference or physical requirements. You can assist us by advising nursing staff, your doctor and the menu monitor of any special or specific needs. If you require a modified diet or have special dietary needs, this can be arranged through your nurse, dietitian or speech therapist. Our eight day cycle menu changes in Autumn and Spring to reflect availability of fresh seasonal produce. Should you require a light diet, this can be arranged through your nurse, menu monitor, or dietitian. If you request a light diet item for the same day, choices may be limited between meal times.

13 13 During your stay Meal service times Breakfast 7.00am to 8.30am Lunch 11.30am to 1.00pm Dinner 5.15pm to 6.45pm A trolley service is also available as follows: Morning tea 9.30am to 10.15am Afternoon tea 1.30pm to 2.15pm Supper 7.30pm to 8.15pm Our Food Services Team Chefs We have a team of highly experienced chefs involved in menu planning and food preparation, aiming to produce enjoyable, well presented and nutritious meals and snacks. Menu monitors Our menu monitors will visit you each morning from 8.30am onwards to take your meal order via an electronic ordering system. They can also assist you with menu choices and special diet requests. Dietitians Our dietitians are trained to assist with the nutritional needs of patients before, during and after hospitalisation. They are available to provide information and support to meet your needs and assist with recovery. Medical events and trauma can have a profound effect on metabolism and nutritional requirements. Poor nutrition can increase fatigue levels, decrease wound healing and delay recovery. The dietitian can develop a diet plan tailored to your needs to improve nutrition and aid recovery. Meal and snack delivery staff Our food service staff will endeavour to deliver your meals in a timely manner and are available to provide assistance with opening packaging. Your meal tray is normally collected 30 minutes to one hour after it is delivered but if you need more time that will be accommodated. Our menu We aim to provide a wide selection of food on our menus from meat to fish and vegetarian choices. The food choices have been developed with input from patients, dietitians, chefs and our staff. We provide a balance of comfort and modern choices with the aim of meeting the food preferences and cultural needs of our patients. Commonly asked questions about your meals What if I miss a meal? If you are away from your room during meal or snack delivery time, please ask your nurse to organise something to eat and drink on your return.

14 14 During your stay Can I order wine or beer with my meal? Alcohol is provided only with the permission of your treating doctor and can only be provided accompanying a meal. What if my meal is delivered and it is not what I ordered or is missing something? If your meal arrives and it is not what you thought you ordered on the menu or if something is missing please speak with your nurse. Can I order something that is not on the menu? Yes, discuss your preferences with your menu monitor and they will endeavour to meet your request. Meeting your special needs Epworth has a diverse patient population. We recognise that many of our patients have special needs in accordance with culture, religious beliefs, personal preferences, physical abilities and disabilities and we aim to ensure that these needs are met. Examples of services that can be organised to meet your needs include: Interpreter services Dietitians Religious and pastoral care staff Occupational Therapists Social Workers Your nurse and nurse manager Please identify any special needs or requirements to your nurse, doctor or therapist so that we can accommodate your requests. Non smoking policy All Epworth sites are smoke free. Smoking is not permitted in the hospital or on hospital grounds for patients, visitors and staff. Payphones Payphones are located in the Bridge Road foyer and on Level 2 near the EpiCentre Cafe. Telephone Each bed has its own telephone, enabling your family and friends to dial you directly. Please ask your nurse or ward receptionist to assist you in locating your direct telephone number. Local, STD and international calls can be made from your bedside telephone. Local calls are complimentary; however there are charges for calls to mobile phones and for STD and international calls. Special telephones are available for patients with impaired vision or hearing, or for patients who are unable to hold a hand piece.

15 15 During your stay Valuables Each patient room in the new Lee Wing has a personal safe for storing valuables (eg electronic items) similar to those in hotel rooms. However we recommend that you do not bring non-essential valuables to hospital (e.g. jewellery). While Epworth will endeavour to take every possible care of your personal property it does not accept any liability or responsibility for theft, loss or damage to your personal belongings (this includes dentures, hearing aids and/or glasses). Visitors Visitors are welcome daily from: 11am 1pm and 3pm 8pm At the start and end of the rest period you will hear a harpist playing through the overhead audio system. We ask that all visitors work with our healthcare team to respect our patient rest periods. Long visits may tire patients, so please show consideration and stay for short periods only. We also ask that visitors are considerate of other patients and keep noise levels low when visiting, and supervise children at all times. In the interest of all patients, if you feel unwell or know you have a cold or flu please refrain from visiting until your health improves. Please encourage others to take similar protective measures. Quiet hospitals help healing Rest is an important part of our patients healing process. To ensure every patient has an opportunity to rest we have a dedicated rest period each day. Our rest period is between 1pm 3pm in all wards.

16 16 Your care team Your doctor You can work with your doctor by: being as open and accurate as possible with information about your health asking questions if you would like clarification or more information complying with agreed treatment plans to the best of your ability joining in decision making about your care. You can expect from your doctor: to identify himself or herself and to explain their professional status to be informed of and to give consent to any procedure where consent is required by law freedom to refuse treatment after being informed of the medical consequences of such a refusal freedom to seek a second opinion. Your nurse Your nurse is your primary carer. You can ask your nurse to: arrange for an interpreter service arrange for pastoral care to visit you arrange for the business office to explain costs and billing procedures arrange for a pharmacist to explain your medications contact your doctor regarding your medical treatment assist with any queries about your discharge plan. Allied Health and in-patient Epworth services Epworth Richmond promotes a multidisciplinary team approach to patient care, overseen by a doctor. While in hospital, patients may access the services of Epworth allied health professionals including physiotherapists, occupational therapists, speech pathologists, psychologists, social workers and dietitians. Other services that are less frequently required, such as podiatry, may require an external provider (not a staff member) to be called in. In such cases there will be some cost to the patient, depending on the coverage provided by the health fund. Referrals to the relevant allied health professional will usually be on instruction from the treating medical consultant. Please feel free to discuss your needs with your nurse or doctor. A diabetes educator is also available for patients and their families or carers, to provide information and advice on diabetes management, equipment and available community services.

17 17 Your care team Pastoral care Pastoral care at Epworth embraces both the secular and the sacred. We offer people the chance to express concerns or issues related to their overall spiritual and emotional health and wellbeing. Members of the pastoral care team can spend time with you, listening to you and offering support. Pastoral care is offered to patients, families and staff by qualified pastoral care staff and chaplains. Support is offered regardless of religious or other beliefs and no attempt is made to intrude or impose particular beliefs. Accredited visitors from various faith traditions visit regularly or on request. We attempt to offer timely and appropriate support, especially at times of acute anxiety and loss. We also want to ensure that the religious and cultural needs of all patients are met and respected. You are warmly invited to attend the brief worship service conducted in the chapel each Sunday at 10am. The service is also relayed on channel 508 on your television. Volunteers Epworth Richmond has an active volunteer program. Volunteers provide a vital service in a wide range of activities through the hospital and are much appreciated by patients and staff alike. If you are interested in further information about the program, or in becoming a volunteer worker, please visit the Epworth website and search Volunteer or contact our Volunteer Coordinator on Pastoral care is available either by staff request or direct calls to extension Patients, family and friends are welcome to use the chapel, located on Level 2 in the Cato Wing, for prayer, meditation or quiet time.

18 18 Your safety in hospital Quality and safety are at the core of everything we do. Epworth runs a number of initiatives which contribute to providing a safe environment for patients, visitors and staff members. Our accreditation and national safety standards also guide Epworth in ensuring your safety. Patient identification On your admission to Epworth Richmond two identifying bands will be placed on your wrist or sometimes your ankle. This band includes your name, date of birth and a unique hospital identification number. Please ensure that all details are correct. Our staff will check your bands on many occasions during your stay, for example before administering medication or conducting blood tests. This helps to ensure that you receive the correct medication or treatment. Consent You or the person responsible for your care would have signed a consent form before your procedure could take place. You should have reviewed all the information on your consent form before you signed. It is important to have discussed your procedure with your doctor so you fully understand everything involved. If you are not sure about anything, including known risks, recovery or alternatives to having your procedure, please ask your doctor. If you have appointed an Enduring Power of Attorney (Medical Treatment) you should have brought a copy of the document with you to hospital to be filed in your medical record and to allow your healthcare team to be aware of this appointment. Blood clot prevention A stay in hospital can increase the risk of a blood clot in your legs or lungs. During your stay the doctor will assess your risk of developing a clot and may recommend a suitable treatment such as wearing compression stockings, taking blood thinning tablets or a blood thinning injection, staying mobile with suitable exercises and adequate hydration/fluids. You can assist in preventing a clot by wearing the stockings for as long as instructed, continuing with the medication and keep moving (within your restrictions). Fall prevention For many reasons patients of all ages are at increased risk of having a fall while in hospital. Being in an unfamiliar environment, changes in medication, altered strength due to an illness, altered balance and some medical conditions can contribute. Epworth has a falls prevention program in place for your safety. During your admission, you will have been assessed to see if you are at risk of having a fall. During your stay, your healthcare team will check on you regularly to ensure you have everything you need within reach and assist you to move around, if needed. Your risk assessment for falls will be repeated throughout your hospital admission, as your risk factors may change. Please ensure your clothing is not too long and footware is non-slip and fits well. Good nutrition, plenty of fluids and suitable exercise are important to maintain your health and reduce your chance of having a fall. Ask your doctor, nurse or physiotherapist about suitable exercises to assist with mobility or let us know if you would like to speck to a dietician. Pressure injury prevention Pressure injuries are caused by pressure, friction and moisture that can damage the skin and result in a sore, tender and sometimes broken area of skin. Epworth has a pressure injury prevention program in place for your wellbeing. During your admission, you will have been assessed to see if you are at risk of

19 19 Your safety in hospital having a pressure injury. The nursing staff may check the common pressure points such as buttocks, heels, elbows and back of head during your stay and discuss how to prevent injuries. You can assist in the prevention of a pressure injury by taking care when you move, ensuring your skin is clean and dry, eating a well balanced diet, staying hydrated and notifying the staff if you have any discomfort. Minimising the risk of infection Epworth is committed to ensuring the health and safety of all patients, visitors and healthcare workers. Our infection control standards are in line with legislative guidelines and the Australian Government Department of Health and Ageing Infection Control Guidelines. We are committed to keeping our patients and visitors as safe and as healthy as possible. When you are unwell your body s immune system is weaker, so the risk of getting an infection is greater. One of the best ways to prevent infections from spreading is to keep hands clean at all times. Please use the hand gel provided in public and patient areas to ensure your hands are clean. You should try not to touch any dressings, wound, drips or tubes on your body. Posters are displayed throughout the hospital with instructions on how to maintain hand hygiene. Safe mobilisation Epworth has safe work practices for staff to use when handling, transferring or mobilising patients. Staff will encourage your assistance whenever it is safe for you to do so. At times a physiotherapist may be consulted to assess and provide strategies for optimising functional mobility. This will ensure you remain as independent as possible, improve your mobility and may also speed your recovery. Equipment that may be used includes slide sheets, an overhead monkey bar, a turning frame, a sit to stand machine or a full lifting hoist with sling. An explanation will be given before any equipment is used. Please ask your nurse if you have any questions about this policy. Promoting recovery Your recovery is very important to us and we seek your active participation in its promotion. The importance of movement It is important to maintain and encourage safe movement whilst in hospital as advised by your care team. Movement can reduce your risk of developing a chest infection, blood clots and pressure injuries. A pressure injury is an area of skin that has been damaged due to unrelieved and prolonged pressure, also known as pressure sores or bedsores. A staff member will examine you and ask general questions about your health, nutrition and mobility to assess your risk of potential complications and give you advice accordingly. Types of movement you may be advised to undertake may include deep breathing and coughing, changing your position or gentle exercises in the bed or the chair. Early mobilisation out of bed under the direction of hospital staff is an important means of promoting a speedy recovery from acute illness or surgery and returning to normal activities. Methods of mobilisation including sitting out of bed or walking depending on your level of ability following surgery/illness, and may require use of specialised equipment and more involvement from physiotherapy staff.

20 20 Your safety in hospital If your length of stay in hospital is greater than 48 hours, please come prepared with a few items of clothing and footwear suitable for walking or exercising. Drinking enough to ensure that you are well hydrated promotes recovery and prevents complications such as blood clots and urinary tract infections. Deep breathing and coughing whilst you are sitting or lying for long periods can help to prevent complications such as chest infections. Ask your nurse or physiotherapist to help you and ensure you have enough pain relief to perform these exercises. A period of rehabilitation may be prescribed or recommended by your doctor or other health professionals such as a physiotherapist. Patient rounding During your admission you will have passed through a number of different areas within the hospital. These may include reception, the admissions lounge, operating theatre, recovery area and the ward. You will be cared for by a number of different medical, nursing and support staff members. For this reason, and to ensure your safety, staff need to check a number of things with you, including your personal details, type of procedure and pain levels. The questions we ask may seem repetitive, but it is a very important part of a patient safety process called rounding. Rounding is a term used at Epworth for the communication staff have with their patients. Rounding is our system of keeping patients informed and safe. There are two types of rounding hourly and leader. Hourly rounding Hourly rounding ensures a high standard of care occurs consistently throughout hospital admission and any risks associated with hospitalisation are managed. Hourly rounding assists staff to build a relationship of trust with you. In turn, you will know what to expect with your day to day care. You can expect to: be informed and involved in care decisions be assessed frequently for pain, comfort, personal needs and have each adequately addressed have items you need left within reach be made aware of when staff will return to continue care. Leader rounding An Epworth expectation is that you will be seen daily by the unit manager, one of their associates or the person in charge of the shift. This assists in ensuring you receive high quality care and that any of your concerns are addressed. Bedside handover Epworth staff are committed to keeping you safe. Bedside handover is an exchange of information about patient care between members of the healthcare team. It is an important communication process that ensures consistency in information exchanges and includes: introduction of staff providing care an overview of the patient s current situation, condition and treatment needs observations and risk assessments review of medications ongoing care requirements.

21 21 Your safety in hospital Epworth staff will invite you to participate in the handover process and you will be provided with an opportunity to clarify the information provided Escalation of care Epworth has systems in place to escalate care as required. Epworth Richmond provides an escalation and review process which is conducted by a Hospital Medical Officer and Intensive Nurse Care Unit Liaison team. As a patient or carer of a patient, it is important that you are actively involved in your/their care. If you notice a change in your/their condition and are concerned, please contact your healthcare team to seek further advice.

22 22 Planning for discharge Discharge planning is an important part of your care. Planning for your discharge commences on admission and continues throughout your stay. This ensures that any services that you require at the time of discharge can be arranged in a timely manner, such as rehabilitation, in-home care, pharmacy or transportation. A member of our nursing staff will explain any special instructions for your care following discharge and a pharmacist will provide information about medications you may need. You will be given written instructions to help you remember what you need to do. Once at home, it is important that you follow these instructions. Your doctor will provide you with information about when you can start driving again or returning to activities such as work. Discharge time for overnight patients is by 9.30am. Once you have been medically discharged you may be transferred to the discharge lounge. The discharge lounge provides easy access to the Erin Street entrance for collection by family, carers or country ambulance transfers. A Slade pharmacist provides education and medication supplies between 9.45am and 10.00am. Tea and coffee is available and lunch is provided to patients waiting for late or country transfers via ambulance. Before discharge you will need to consider the following: transport arrangements to return home capacity to care for your personal needs (e.g. bathing, dressing) capacity to perform normal domestic duties (e.g. shopping, cooking, cleaning) readiness to resume normal social and work activities special care needs (e.g. changing dressings, taking medications). Please ask your doctor and nursing staff to assist you in identifying your specific needs. You may consider asking family or friends for support in meeting these needs. Alternatively your nurse can refer you to a social worker or care coordinator who can assist with arranging support. If returning directly home is not appropriate, your doctor, social workers and nursing staff are available to discuss your options. Medications Prior to leaving the hospital your medication will be reviewed by your doctor and you may require additional medications to be dispensed as part of your discharge. You may also receive a medication profile from the pharmacist which lists the medications that you are currently taking, including the medication name (generic and brand names), purpose, current dose, directions for administration and possible side effects. Please show this list to your general practitioner (GP) after dishcarge and keep it up to date with any changes. Bring this list and any medications that you are taking (in the original packaging) during future hospital admissions. Responsibility for the cost of medications prescribed during your hospital admission are outlined in the accounts and out-of-pocket costs section (page 26). Slade Pharmacy is the service provider for Epworth Richmond further information on Slade Pharmacy can be found on page 10.

23 23 Planning for discharge Rehabilitation As part of our commitment to providing excellence in care, Epworth provides multidisciplinary, individualised specialist rehabilitation programs for patients requiring both inpatient and outpatient rehabilitation care. Rehabilitation is an active process of working with you to maximise your function and improve quality of life either following a major health event such as surgery or a severe illness or in response to deteriorating health related to a chronic condition. Our specialist team of medical, nursing and therapy staff partner with you to tailor a program to meet your individual needs as we aim to work towards returning you to as independent and functional a lifestyle as possible. Our programs include: Orthopaedic (post surgery or fractures) Neurological (post stroke or other neurological conditions) Cardiac Oncology Respiratory Reconditioning (post complex surgery, medical illness, falls and balance program) Pain management. Our specialist rehabilitation hospitals are located at: Epworth Brighton Epworth Camberwell Epworth Hawthorn Epworth Richmond Epworth Geelong. Mental health Epworth Clinic, located at Epworth Camberwell, is a comprehensive mental health service providing a multidisciplinary team approach to the treatment of mental health conditions. Our team consists of psychiatrists, mental health nurses, occupational therapists, psychologists, social workers and general practitioners. We strive to provide excellent patient care in both our inpatient and outpatient programs. We believe that every patient is unique and are committed to offering services that are focused on the individual treatment objectives of every patient. The 63-bed inpatient service provides care and treatment for patients in need of acute rather than crisis mental health care. Epworth Clinic treats a range of mental health conditions such as: mood disorders (depression and bipolar disorders) anxiety (including post traumatic stress disorders) psychosis personality disorders adjustment disorders aged psychiatry neurostimulation (ECT and TMS). For referral to the rehabilitation or mental health programs, please speak to any one of your health care team members. Following this one of our rehabilitation assessment team will visit you to discuss your options as either an inpatient or outpatient.

24 24 Planning for discharge Hospital in the Home The Hospital in the Home Unit (HHU) offers clients the advantages of home nursing and medical care for acute conditions that would otherwise require care in a traditional ward. The team is committed to providing optimal personalised healthcare and meeting the individual needs of clients. Clients have access to medical and nursing contact 24 hours per day, just a phone call away if concerns arise. Client care involves the nursing staff and the medical team visiting the patients at home daily. Clients are considered as inpatients of Epworth, with the advantages of home nursing and medical care, and the hospital s resources such as pharmacy, pathology and radiology available as necessary. External care services, such as housekeeping, meals provision, and personal care can be arranged as necessary. The service requires a referral from a medical officer. For further information on the service please call

25 Accounts and out-of-pocket costs 25 Epworth HealthCare is a private not-for-profit hospital group. As a patient, you will incur fees which are made up of several components. Staff from the Patient Services Centre can advise you of the hospital fees that you can expect to pay, depending on your level of health cover. Things to check with your private health insurer Before coming to hospital, we recommend that you have contacted your private health insurer to check the following: Is your reason for admission, including any surgery, covered under your level of insurance? Are there are any additional costs you should expect such as an excess or co-payments? Self-insured patients If you do not have private health insurance an estimate of your admission costs has been calculated for you and you would have been required to pay your estimated account prior to your admission. The actual cost incurred may differ from the estimate due to a change in treatment or a longer stay in hospital than originally planned. If treatment costs exceed the estimated amount, you will be asked to pay the difference before going home. For further information, please contact the patient service centre. Payment of account You will have been contacted prior to admission to inform you of any estimated out-of-pocket expenses that may apply to you. This may include excesses, copayments and additional costs which are required to be paid prior to your admission. Any outstanding amount not covered by your insurance that has not been paid on admission is due to be paid on discharge. For more information on the types of expenses that may be associated with your stay, please visit epworth. org.au and go to the hospital fees page. Epworth accepts Visa, Mastercard, cash, bank cheques and EFTPOS. We do not accept American Express, Diners Card or personal cheques. If paying by card, please ensure that any daily or transactional withdrawal limits are sufficient to settle your account. For your convenience, accounts may be settled up until the day before discharge. We recommend you do so to avoid receiving multiple accounts after discharge, especially if you have been admitted to another hospital. If you have any questions regarding accounts, please contact the service or department who sent you the account. Billing your private health insurer Epworth will submit a claim to your private health insurer for the cost of hospital related expenses, for the following group of patients: Privately insured patients Department of Veterans Affairs (DVA) patients WorkCover, TAC and other third party claims (only if a letter of liability is provided). All doctor, medical and anaesthetic fees will be billed separately by your practitioner. Take any of these accounts to Medicare and then to your private insurer. Any queries around these accounts should be directed to the practice issuing the account.

26 Accounts and out-of-pocket costs 26 Additional costs from external providers During your admission you may require tests to provide your treating doctor with a diagnosis or to help monitor your medical progress. Costs for these services will be billed separately by third party providers and may include: pathology (blood or tissue samples) diagnostic imaging (x-rays) services, and/or medications dispensed to you from the pharmacy during your admission or on discharge (for unrelated or pre-existing medication needs). Epworth has no gap agreements with many health funds to fully or partly cover the costs of pathology and radiology tests. Fees may be reduced if you have an eligible government entitlement or discount card. Please speak to the provider directly for further information: Epworth Pathology: ph Epworth Medical Imaging: ph Slade Pharmacy: ph Medication costs Responsibility for the cost of medications prescribed during your hospital admission are outlined below: the cost of medications relating to your immediate treatment while in hospital will be covered by the hospital if you were taking regular medications before you entered hospital and these medications need to be resupplied during your admission, the cost of these medications is your own responsibility the cost of medications prescribed and supplied at the time of discharge from hospital are also the patient s own responsibility. If there is an amount owing for medication dispensed to you during your hospital stay please arrange payment direct to Slade Pharmacy (located at the Bridge Road entrance) before leaving. For any medication queries, please contact Slade Pharmacy ph between 8am and 10pm, seven days a week. For account queries, please contact Slade Pharmacy Accounts Department ph

27 Epworth Medical Foundation 27 Supporting patient care Epworth Medical Foundation (EMF) opened in 1982 to raise much-needed funds to ensure patients at Epworth receive the best possible care. Our work is vital, because Epworth is a charitable, not-forprofit hospital, and receives very limited government funding. Epworth relies on funds raised by Epworth Medical Foundation to continue to provide our patients with the best possible facilities, equipment, surgical expertise and access to research. We rely on your generosity to enable us to stay at the forefront of advancements in medical technology, for our patients. The difference you make When you donate to the Foundation, your generosity is used to directly benefit our patients. For example, more than half of all medical equipment is funded by the Foundation, as is 80 percent of our medical research. Charitable funds are used to support: advanced medical equipment that ensures our patients receive the very best world-class facilities that maximise patient outcomes, safety and comfort groundbreaking medical research projects and trials, shared with our patients staff education and training opportunities to pass best-practice on to our patients support programs to care for our patients emotional and financial needs. Fundraising activities Epworth Medical Foundation hosts numerous events throughout the year, including the famous Epworth Gala Ball, a series of exciting national and international charity challenges, the prestigious Men s Health and Women s Health events, and a number of other activities. In addition, we run a number of special appeals that enable our donors to directly impact the care that our patients receive, and provide opportunities for our supporters to establish a legacy of philanthropy that lasts forever through named buildings, endowed scholarships or research projects, and bequests. For further information on fundraising activities and sponsorship opportunities, please phone

28 Compliments and complaints 28 Provide feedback or make a complaint You have a right to give positive or negative feedback, ask questions and make complaints about your care. At Epworth we are constantly striving to provide patients with the highest possible level of care. Feedback that we receive from our patients, both positive and negative, helps us to improve the services we offer. If you wish to provide a compliment or a complaint, in the first instance, speak to your nurse or nurse unit manager. If they are unable to assist, you can request to speak to the hospital patient liaison coordinator or you may prefer to leave feedback via the Patient Feedback page on the Epworth website epworth.org.au Written feedback may also be directed to: Executive Director Epworth Richmond 89 Bridge Road, Richmond VIC 3121 Patient concerns and complaints are investigated in accordance with procedural fairness and respect, and will in no way adversely affect the care and treatment provided to you. If you are not satisfied with how we are responding to your concerns, you have a right to complain to the Victorian health services commissioner.

29 Private Patient s Hospital Charter 29 PPHC PRIVATE PATIENTS HOSPITAL CHARTER Your rights and responsibilities as a private patient in a public or private hospital As a private patient you have the right to choose your own doctor, and decide whether you will go to a public or a private hospital that your doctor attends. You may also have more choice as to when you are admitted to hospital. Even if you have private health insurance you can choose to be treated as a public patient in a public hospital, at no charge, by a doctor appointed by the hospital. Information about your treatment - Your doctor should give you a clear explanation of your diagnosis, your treatment (and any associated risks), the associated cost, and other treatment options available. Except for in an emergency where it is not possible, they should obtain your consent prior to any treatment. Informed Financial Consent - Your doctor and other health service providers should provide you with information about the costs of your proposed treatment, including any likely out-of-pocket expenses, and obtain your agreement to the likely costs in writing before proceeding with the treatment. Other medical opinions - You can ask for referrals for other medical opinions (there may be additional costs associated with doing this that may not be covered by Medicare or your private health insurance). Visitors - The hospital you are going to can provide information about visiting arrangements for your family and friends while you are in hospital including family access (and who is considered family), arrangements for the parents or guardians if the patient is a child, and when your friends can visit you. Seek advice about costs - As a patient with private health insurance, all your hospital treatment and medical bills may be covered by your insurance, or you may have to pay some out-of-pocket expenses (gaps). In some cases you may also have to pay an excess or co-payment. Before you go to hospital, ask your private health insurer, doctor(s) and hospital about the expected costs of your treatment, including possible costs for surgically implanted medical devices and prostheses. (See overleaf for some suggested questions to ask about costs). Confidentiality and access to your medical records - Your personal details will be kept strictly confidential. However, there may be times when information about you needs to be provided to another health worker to assist in your care if this is required or authorised by law. You will need to sign a form to agree to your health insurer having access to certain information to allow payments to be made for your treatment. Under the Freedom of Information legislation you are entitled to see and obtain a copy of your medical records kept in a public hospital. Under the National Privacy Principles you also have a general right to access personal information collected about you by the private sector. Treatment with respect and dignity - While in hospital you can expect to be treated with courtesy and have your ethnic, cultural and religious practices and beliefs respected. You should also be polite to your health care workers and other patients and treat them with courtesy and respect. Care and support from nurses and allied health professionals - Nurses and allied health professionals provide vital care and support and are an important part of your treatment in hospital. Staff who attend you should always identify themselves and you should feel confident to discuss any issues in relation to your treatment or hospital experience with your health care workers. Participate in decisions about your care Before you leave hospital you should be consulted about the continuing care that you may need after you leave hospital. This includes receiving information about any medical care, medication, home nursing or other community services you may need after you go home. Comments or complaints - If you are concerned about any aspect of your hospital treatment you should initially raise this with the staff caring for you or the hospital. If you are not satisfied with the way the hospital has dealt with your concerns, each State and Territory has an independent organisation that deals with complaints about health services and practitioners. If your query or complaint relates to private health insurance, you should first talk to your health insurer. If your concerns remain unresolved you can contact the Private Health Insurance Ombudsman on (freecall). Provide accurate information - To help doctors/specialists and hospital staff provide you with appropriate care you will need to provide information such as family and medical history, allergies, physical or psychological conditions affecting you, and any other treatment you are receiving or medication you are taking (even if not prescribed by your doctor). Long-stay patients - If you are in hospital for a long period of time you may become a nursing home type patient. Talk to your hospital or health insurer about the arrangements for long-stay patients. Find out about any potential costs before you go to hospital Ask your treating doctor or specialist: - for confirmation in writing of how much their fee will be and how much is likely to be covered under Medicare or your private health insurance. - whether they participate in your health insurer s gap cover arrangements and if you are likely to have to pay a gap, how much it will be. - which other doctors and medical staff will be involved in your treatment and how you can get information about their fees and whether they will be covered by your private health insurance. - for an estimate of any other costs associated with your medical treatment that may not be covered by Medicare or your private health insurance (e.g. pharmaceuticals, diagnostic tests). - whether you are having a surgically implanted device or prosthesis and if you will have to contribute towards the cost for this. Ask your health insurer: - whether the treatment you are having is covered by your private health insurance and if there are any exclusions or waiting periods that currently apply to this treatment under your policy. If you are having a baby, talk to your health insurer as early as possible in your pregnancy to find out what rules apply to obstetrics and newborn babies. - whether you have to pay an excess or co-payment, and, if so, how much this will be. - about the level of hospital accommodation covered by your policy (some policies only cover being a private patient in a public hospital). - whether your insurer has an agreement with the hospital you are going to be treated in. - whether you will need to pay extra for surgically implanted devices or prostheses. - if any gap cover arrangements are in place that may apply to you. Ask your hospital: - whether the hospital has an agreement with your private health insurer. - whether you will have to pay anything for your hospital accommodation out of your own pocket. - whether you will have to pay any additional hospital charges which are not covered by your private health insurance (e.g. TV hire, telephone calls). PI1210_0616